E-cigarette use in Colorado is twice the national average

Fighting the epidemic

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Colorado and El Paso County see higher-than-average rates of teen vaping.

In the 1990s, R.J. Reynolds Tobacco Company faced a flurry of accusations that they had used Joe Camel, a hip cartoon dromedary who wore sunglasses, to attract young people to their cigarettes. For decades, RJR and other cigarette companies had marketed their products via radio, television and movies, leading to a federal government crackdown on tobacco advertising, especially any targeting young people.

Fast-forward to today, when Dacia Hudson, program manager for the Tobacco Education and Prevention Partnership at El Paso County Public Health, believes history is repeating itself through the advertising campaigns for e-cigarette companies.

While some view e-cigarettes as a healthier alternative to traditional cigarettes, e-cigs have come under fire as new health concerns caused by inhaling the chemicals used to flavor e-cigarette “juice” have come to light. And Hudson says more long-term health effects are expected to surface over time.

“That’s the challenge that we’re up against with the teen vaping epidemic, is the marketing and misinformation,” she says. “The tobacco industry is known for their heavy-hitting, very well done marketing campaigns, and the e-cig companies are duplicating that by targeting youth and saying they are a healthier option.”

Often, as seen with the popular e-cigarette brand Juul, companies advertise their products as a healthy alternative to smoking cigarettes, although Hudson says there isn’t evidence to support that.

E-cigarette marketing isn’t covered by federal advertising laws that impact cigarette companies. And in Colorado, as in most states, e-cigarettes aren’t subject to excise taxes that are applied to cigarettes.

“E-cigarettes or vape devices are the second most used substance by youth behind alcohol,” Hudson says. “I think a lot of people think that our problems lie with marijuana, but that’s the third[-most] substance being used, and not that we shouldn’t pay attention to that, but e-cig usage definitely seems to be more on the rise.”

Teen e-cigarette use in Colorado is twice the national average, according to the Colorado Department of Public Health and Environment. And e-cigarettes are the most common tobacco product used by teens both statewide and in El Paso County. About 23 percent of youths smoke e-cigarettes in El Paso County while roughly 7 percent use traditional cigarettes, according to the Healthy Kids Colorado Survey.

The state’s health department surveyed 56,000 middle- and high-schoolers last year. It was El Paso County’s first representation in the data since 2013.

“We’ve known that vaping has been on the rise for a few years, but not to the degree that we know now,” Hudson says. “It was pretty alarming to see how big of a problem we have on our hands not only in El Paso County, but all of Colorado.”

Nationwide, sales of vape devices have increased 132 percent from 2012-16 while prices fell, according to a study released last summer by the Centers for Disease Control and Prevention.
In recent years, e-cigarette ad spending has significantly increased, from $6.4 million in 2011 to $115 million in 2014, according to the CDC.

More than 18 million (70 percent) middle- and high-schoolers nationwide were exposed to some type of e-cigarette advertising in 2014.

Patrick Maroney, director of the Colorado Liquor Enforcement Division, says the state doesn’t have any laws regulating e-cigarette marketing.

“Those types of laws normally are done at the federal level but don’t really exist yet,” he says, adding state lawmakers could decide to pass legislation.

Gov. John Hickenlooper signed an executive order in November addressing the “teen vaping epidemic,” in which he recommended more checks on retailers that sell e-cigarettes.

The division doubled its tobacco outlet-checking efforts in November and December, Maroney says, with a targeted emphasis on e-cigarette retailers.

His staff completed more than 1,000 compliance checks starting in July through the end of last month.

“Our current number of violations across the board is about 9 percent,” he says. “So of the 1,077 places checked, 97 were not in compliance.”

During the state’s previous fiscal year, which runs July to June, the number of violations was 7.9 percent, Maroney says.

“We have really increased the number of checks we are doing at retail outlets, and we will, going forward, as long as resources allow,” he says.

About 56 percent of El Paso County youth reported it is easy to get cigarettes and e-cigarettes, according to the Healthy Kids Colorado Survey.

Data indicates cigarettes are illegally obtained mainly at gas stations, whereas the internet is the most popular source for procuring e-cigarettes (not including other suppliers such as friends and family members).

Maroney says the division doesn’t monitor internet sales, nor are there state laws specific to the online sale of e-cigarettes.

“There’s no specific laws or rules that address online purchases, but what the law says is you may not sell to someone who is under 18,” he says. “Now, how that is accomplished is currently up to both the person selling and the person purchasing.”

Hickenlooper also proposed lawmakers take steps to further regulate vaping devices, including raising the minimum age for purchasing tobacco and e-cigarettes from 18 to 21.

Emma Cook, a community health educator for the county’s Tobacco Education and Prevention Partnership, says the move would help “cut out the middleman,” or friends getting them for younger classmates.

“The thought is if you’re 21, hopefully you’re not still hanging out with someone 17 or younger,” she says.

The executive order also recommended legislators extend the existing excise tax on tobacco products to e-cigarettes.

According to Daniel Carr, taxation communications manager for the Colorado Department of Revenue, the excise tax for tobacco products is 4.2 cents per cigarette or 84 cents per pack of 20 cigarettes. “E-cigarettes and nicotine patches are not considered tobacco products under the taxation statute, therefore are not subject to the tobacco products excise tax,” he says, adding the majority of states don’t have excise taxes on e-cigarettes. As of September, only nine states and the District of Columbia had some form of tax for e-cigarettes, according to Public Health Law Center’s Tobacco Control Legal Consortium.

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Designed by Melissa Edwards, CSBJ

Meanwhile, Hickenlooper’s order also asked state lawmakers to start requiring all tobacco product retailers, including those that sell e-cigarettes, to be licensed.

Colorado is among a handful of states that don’t have tobacco licensing for retailers, Maroney says.
“My staff is held liable or we’re supposed to keep up the best list possible of the number of tobacco outlets, and without having a licensing scheme, it’s difficult to do that,” he says. “But, we feel that we’re well over 90 percent accurate on the number of tobacco outlets out there.”

Maroney says investigators surveying the state for tobacco retailers and checking lists from the Colorado Department of Revenue are among the ways the division creates its list.

“There’s a variety of ways we try to keep our list up, but it absolutely would help to have some sort of licensing,” he says. “It also would allow us to suspend or revoke retailers’ ability to sell tobacco products.”

In Colorado, if a business is caught selling to a minor 10 times, it will face increasing penalties, Maroney says.

“There is no stopping them completely because there is no licensing,” he says.

The governor’s order came a month after the FDA warned e-cigarette manufacturers to address the “teen vaping epidemic,” facilitated by Juul, Vuse and other popular brands.

Ted Kwong, a spokesman for Juul Labs, told The Denver Post via email in November that the San Francisco company supports raising the purchasing age for e-cigarettes.

“While we believe flavors play an important role in helping adult smokers switch to vapor technology, we also support reasonable regulation to restrict advertising and naming of inappropriate flavors such as ‘cotton candy’ and ‘gummy bear’ that are directed at children,” he says in the statement to the Post.